神经发育障碍儿童照护者心理健康水平及影响因素分析

Analysis of Mental Health Level and Influencing Factors of Caregivers of Children with Neurodevelopmental Disorders

摘要: 目的：调查神经发育障碍(neurodevelopmental disorders, NDDs)儿童照护者心理健康水平，探讨养育倦怠程度、心理弹性水平、社会支持度对神经发育障碍儿童照护者抑郁的影响，为减轻照护者抑郁提供理论依据。方法：选取2023年12月~2024年5月在重庆医科大学附属儿童医院康复科门诊就诊或住院的317名NDDs儿童的主要照护者作为研究对象，采用一般资料调查表、抑郁自评量表SDS (Self-Rating Depression Scale, SDS)、养育倦怠评估量表(Parental Burnout Assessment, PBA)、心理弹性量表CD-RISC (Connor-Davidson Resilience Scale)、社会支持评定量表(Social Support Rating Scale, SSRS)进行调查，采用Pearson相关性分析养育倦怠程度、心理弹性水平、社会支持度与照护者抑郁的相关性，采用多元回归分析影响NDDs儿童照护者抑郁的因素。结果：1) 本研究中SDS评分为(51.98 ± 10.54)分，51%照护者存在抑郁；PBA评分为(26.75 ± 25.62)分，照护者普遍经历不同程度养育倦怠；CD-RISC为(60.35 ± 21.38)，心理弹性处于低水平；SSRS评分为(38.74 ± 7.5)，社会支持处于中低水平；2) 家庭关系、家庭类型、照护者健康状况、照护者对患儿疾病了解程度、患儿神经发育障碍严重程度的照护者SDS评分比较差异有统计学意义(P < 0.05)。3) 多元回归分析结果显示，家庭类型、照护者对患儿疾病了解程度、患儿神经发育障碍严重程度、养育倦怠程度、心理弹性水平、社会支持度均为NDDs照护者抑郁的影响因素(P < 0.05)。结论：神经发育障碍儿童照护者抑郁水平普遍较高，社会、临床医护人员应关注神经发育障碍儿童照护者心理健康状态，给予特殊家庭类型、对疾病了解不足、病情严重程度高的儿童照护者更多的关注，加强宣教，引导其积极应对，提高心理弹性水平，加强社会支持度，降低抑郁水平。

Abstract: Objective: To investigate the mental health of child caregivers of children with neurodevelopmental disorders (NDDs), and to explore the effects of parenting burnout, psychological resilience, and social support on depression among child caregivers of children with NDDs, in order to provide a theoretical basis for alleviating caregiver depression. Methods: The primary caregivers of 317 children with NDDs who were outpatients or hospitalized in the rehabilitation department of the Affiliated Children’s Hospital of Chongqing Medical University from December 2023 to May 2024 were selected for the study. The general information questionnaire, Self-Rating Depression Scale (SDS), Parental Burnout Assessment (PBA), Connor-Davidson Resilience Scale (CD-RISC), and Social Support Rating Scale (SSRS) were adopted for the investigation. Employ Pearson correlation analysis to explore the correlations between the degree of parenting burnout, the level of psychological resilience, the degree of social support and the depression of caregivers, and adopt multiple regression analysis to analyze the factors influencing the depression of caregivers of children with NDDs. Results: 1) In this study, the mean SDS score was 51.98 ± 10.54, indicating that 51% of caregivers exhibited symptoms of depression. The mean PBA score was 26.75 ± 25.62, reflecting varying degrees of parenting burnout among caregivers. The mean CD-RISC score was 60.35 ± 21.38, suggesting a low level of psychological resilience. The mean SSRS score was 38.74 ± 7.5, indicating moderate to low levels of social support. 2) Significant differences in SDS scores were observed across family relationships, family types, caregiver health status, caregiver understanding of diseases, and severity of neurodevelopmental disorders in children (P < 0.05). 3) Multiple regression analysis revealed that family type, caregiver understanding of the disease, severity of neurodevelopmental disorder, degree of parenting burnout, level of psychological resilience, and extent of social support were all significant predictors of depression in caregivers of children with neurodevelopmental disorders (P < 0.05). Conclusion: Caregivers of children with neurodevelopmental disorders generally experience high levels of depression. Social and clinical medical staff should prioritize the mental health of these caregivers, particularly those from special family backgrounds, with limited disease understanding, or caring for children with severe conditions. Efforts should focus on enhancing education, promoting positive coping strategies, improving psychological resilience, and strengthening social support to reduce depression levels.